Long‐term follow‐up of congenital hydronephrosis in a single‐center study

Abstract

ObjectivesMany congenital hydronephroses spontaneously resolve. This study evaluated a long‐term follow‐up of more than 4 years of patients with congenital hydronephrosis at a single center.MethodsIn total, 215 patients (286 kidneys) with congenital hydronephrosis were included. Hydronephrosis outcomes (resolution, improvement, and persistence) and time‐to‐outcome were evaluated.ResultsFourteen patients underwent early surgical intervention until the age of 2 years. A total of 189 congenital hydronephrosis cases (66%) showed resolution at a median of 16 months (interquartile range: 7–21 months) and 169 (80%) of 210 kidneys with grade I to II hydronephrosis showed resolution at a median of 14 months (interquartile range: 6–23 months). Of 76 kidneys with grade III to IV hydronephrosis, 24 (32%) showed resolution at a median of 29 months (interquartile range: 24–41 months), and 56 (74%) showed improvement to grade II or less at a median of 12 months (interquartile range: 5–23 months). Of the 76 kidneys with grade III to IV hydronephrosis, five required delayed pyeloplasty at a median of 66 months (interquartile range: 42–89 months). One patient was asymptomatic, with a marked worsening of hydronephrosis and decreased renal function 6 years after the resolution of hydronephrosis.ConclusionsNone of the patients with grade I to II hydronephrosis required surgical treatment, and a shorter follow‐up may be sufficient. Grade III to IV severe hydronephrosis should be considered for a longer and more careful follow‐up, given the possibility of asymptomatic exacerbation of hydronephrosis.